An Analysis of the Urban Issue of Tuberculosisin the Bourough of Newham The WritePass Journal

An Analysis of the Urban Issue of Tuberculosisin the Bourough of Newham 1.Introduction An Analysis of the Urban Issue of Tuberculosisin the Bourough of Newham ). Newham has a population of 308,000 with a population density of 85.1 per hectare as compared to 31 in central London (UK Census, 2012). These figures suggest that even in the populated city of London, Newham is an area of urbanisation, with a large number of people concentrated into a relatively small area. The increase of tuberculosis has been described as a ‘penalty for high density urban living’ (Dye 2010, p.859), likely due to the increased potential for transmission in overcrowding, and the increased rates of immigration to inner-city areas. Bhunu and Mushavabasa (2012) propose that tuberculosis thrives in conditions of overcrowding and poverty, issues that are common in urban areas. The high rates of tuberculosis in cities such as London, and areas of urbanization such as Newham, suggest that the incidence of tuberculosis is indeed an urban issue. Newham fulfills the criteria of high immigration rates and being an area of deprivation.. Newham has a diverse ethnic population, with 61% of the people being non-white (Farrar Manson 2013, p. 54). The population of ethnic minorities continues to grow along with the increasing numbers of refugees and asylum seekers in greater London. Another aspect of urbanisation illustrated in the borough of Newham is that of deprivation and overcrowding. Farrar Manson (2013, p. 16) claim that Newham ranks as the third most deprived borough in inner London. Most of the people here live in tower housing and overcrowded conditions that are the perfect condition for the spread of tuberculosis. There is a positive correlation between poor housing and poverty and the prevalence of tuberculosis, which is very clear in Newham as evidenced by the findings of 108 and 116 cases per 100,000 people (Vassal, 2009; Anderson et al., 2001). The aetiology of the issue of tuberculosis is highlighted when considering the distribution of the disease across Newham. The occurrence of disease is not evenly spread across the borough, with 70% of cases coming from Manor Park, Green Street and East Ham. These boroughs represent areas of population increase, overcrowding and higher levels of those living in poverty. Manor Park and Green Street also show differing dynamics of tuberculosis incidence, representing an overall increase of 40% since 2006 whilst all other areas of Newham either remained static or showed slight decrease (Malone et al 2009, p. 23). It can be seen that tuberculosis presents a significant urban issue, especially when comparing incidence in an urban area such as Newham to those less urbanised areas. Bromley has a population of 309,000 and a population density of 20 per hectare, in comparison to Newham’s population density of 80 per hectare (UK Census, 2012). Tuberculosis incidence in Bromley is between 0-19 per 100,000 compared to that of Newham, which is five times greater at 80-100 per 100,000 (Anderson et al., 2006). It is for this reason that necessary intervention strategies need to be formulated and implemented to help reduce the rates of tuberculosis among individuals living in Newham. 3. The Influence of Urbanisation on Tuberculosis Incidence While the global rates of tuberculosis are declining, the disease is showing steady increase in the United Kingdom. In 2012, 8751 new cases of the disease were identified in the country with 39% coming from London (Fullman and Strachan 2013, p. 43). Indeed London has the highest rates of the disease in Western Europe with Newham borough having the highest rates in the UK. Jindal (2011, p. 55) claims that the rate of tuberculosis in some London boroughs is more than twice higher than the threshold used by the world health organisation to define high rates. These higher incidences support the notion of a sick city hypothesis where there are greater levels of ill health than in rural areas, and may be due to the presence of factors in an urban environment that contribute to ill health (an urban health penalty). One factor that may contribute to the urban health penalty is that of immigration. Cities are easier to access than rural areas, provide areas of congregation and provide more facilities for immigrating families and individuals. The majority of individuals suffering from tuberculosis are people born outside the United Kingdom, with 75% of cases in 2003 being born abroad (Anderson et al., 2006). A reason for the high incidence in those born abroad but now living in the UK is exacerbated by the nature of tuberculosis. On initial infection, tuberculosis is confined by the immune system with only around 5% of cases experiencing symptoms within the first two years of infection (Narasimhan et al., 2013). The remainder of cases harbour a latent infection which may reactivate later in life, with about 10-15% of those infected going on to develop an active disease (Narasimhan et al., 2013). This insidious nature combined with the later activation of the disease explains why many people do not get the disease until later in life. It is likely that it is contracted in their country of birth, however then manifests much later once they have moved to the UK. Statistics indicate that over 90% of the residents in Newham diagnosed with the disease in 2011 were born outside the United Kingdom (Fullman and Strachan, 2013, p. 33). Among these, 50% arrived in the country in the last five years. In the same year tuberculosis diagnosis increased by 25% compared to 2010 (Fullman and Strachan, 2013), possibly as a reflection of the increased immigration. Additionally to a high immigrant population bringing significant disease burden from their countries of birth, London and Newham both represent many of the other issues of urbanisation and urban health penalty that can contribute to the high incidence of tuberculosis. Studies have shown that low vitamin D levels are associated with an increased risk of developing tuberculosis (Campbell and Spector, 2012; Chan, 1999). This is an important association in urban populations, as the living and working conditions foster less access to sunlight (the major source of vitamin D). Additionally, Asian immigrants present a problem of low vitamin D due to vegetarian diets, and a tendency to cover up their skin, not allowing to take advantage of the small amount of sunlight available (Chan, 1999). As previously mentioned, Newham is an area of both high urbanisation and with a large immigrant population, and 38.6% of the population being of Asian descent (London Borough of Newham, 2010). The immigrant population of urban areas such as Newham also present a non-vaccinated proportion of society. Whilst the BCG vaccine against tuberculosis was introduced in the UK in the 1950s and was shown to provide a reduction in risk of contracting tuberculosis (Colditz et al., 1994), those immigrating were less likely to receive this vaccination on moving to the UK. London also represents cases of tuberculosis that are socially and medically complex. As a hugely populated area, London includes those with HIV infection and presents other risk factors such as onward transmission and poor treatment. HIV is one of the most powerful risk factors for tuberculosis, with a incidence rate of 20 times higher in those that are HIV positive (Dye and Williams, 2010). People’s attitudes towards and access to healthcare also present a complex mix of factors which contribute to an increased incidence of many health problems, including that of tuberculosis. Those in impoverished areas have reduced access to healthcare, which may stem from many reasons such as complex needs, chaotic lifestyles, location of services, user ignorance, and language and literacy barriers (Szczepura, 2005). These can affect the disease process of tuberculosis from prevention, treatment of active disease, adherence to treatment and prevention of the health consequences. Especially problematic are misconceptions and a lack of understanding of the disease, leading to late presentation and delayed access to treatment (Figuera-Munoz and Ramon-Pardo, 2008) With the close living quarters in areas such as Newham, the spread of tuberculosis is facilitated. With poverty, poor housing and overcrowding, these areas concentrate several risk factors and lead to a greater spread of tuberculosis (Bates et al., 2004). These determinants therefore suggest that the incidence of tuberculosis in urban areas is a complex issue. Controlling and preventing tuberculosis in London requires effective social and economic tools that must be incorporated in the development of policies of control in treatment initiation. 4. Consequences and implications of tuberculosis on the general population Tuberculosis ranks with HIV/ AIDS and Malaria as one of the three main health challenges currently facing the world. The Commonwealth Health Ministers Update 2009 (2009, p. 41) indicates that 8 million new cases are reported globally each year. As previously mentioned, when combined with HIV, tuberculosis can prove lethal as the two diseases enhance the progress of each other. It is for this reason that tuberculosis is the major cause of death among HIV patients with the rate standing at 11% globally. The World Health Organization (2009, p. 27) indicates that tuberculosis is responsible for more deaths today than ever before, with approximately 2 million lives claimed by the disease annually. As well as the significant mortality contributed by tuberculosis, the morbidity of the disease can be extremely detrimental both socially and economically. Those with the active disease that are not receiving treatment have been shown to go on to infect 10-15 others every year (WHO, 1998). Those who do receive treatment face a long (up to six months) and complex treatment regime involving several medication side effects. This can affect adherence to the treatment regime, and lead to the disease developing a resistance to the treatment, with this drug resistant tuberculosis contributing to greater mortality and increased expense to treat (Ahlburg, 2000). As well as the significant morbidity and mortality, it is important to consider the economic impact of tuberculosis. The World Health Organisation estimated the cost to treat tuberculosis in 2000 as $250,000 US dollars ( £150,000) in developed countries (Ahlburg, 2000). This presents a significant burden to the UK NHS, not to mention the time lost through not working which can dent the economy. London is a global world trade centre whose economy is shaped by global forces, particularly in terms of trade, labour and capital. As a gateway to both the UK and other parts of Europe and the rest of the world, London records a very large number of tourists and immigrant populations. This high number of people accelerates the spread of the disease as people carry it to the country from other parts of the world is indicated by the new infection patterns and is highlighted by the prevalence in immigrant populations. 5. Strategies and intervention for addressing tuberculosis Current UK guidelines for tuberculosis intervention were made by NICE in 2006 (updated 2011). The recommendations propose strategies for identifying those with latent (non-active) tuberculosis to prevent spread or reactivation and also specify criteria for treatment (NICE, 2011). Those recommended for screening for latent tuberculosis include close contacts of infected individuals, immigrants from high incidence countries, immunocompromised individuals, and healthcare workers. Whilst this strategy targets prevention of the spread of tuberculosis, they are only targeting specific groups, and it is likely in high incidence areas such as Newham, people will slip through the net. These guidelines have only changed minimally since 2006, and since then tuberculosis incidence has been on the increase in areas such as Newham, suggesting that changes may need to be made. High incidence areas of the UK such as Newham could learn from New York experience and copy the strategy it used in dealing with the disease. With the implementation of broadened initial treatment regimes, direct observed therapy, and improved guidelines for hospital control and disease prevention, the city managed to halt the progression of an epidemic (Frieden et al., 1995). As mentioned in the previous chapter, adherence to the lengthy treatment regime as well as a lack of understanding may contribute to the spread of tuberculosis. Directly observed therapy (DOT) involves observing the patient take each dose of their medication, with outreach workers travelling to their homes. Evidence from New York showed that through DOT, only 3% of patients in therapy were infectious, compared to a proposed 20% if not receiving DOT (Frieden et al., 1995). Current UK guidelines (NICE, 2006) do not recommend DOT, although they do state that it may be used in cases of patients with previous issues with adherence or at high risk. Although an expensive and time consuming process, if DOT can reduce infectious cases, this would also work as a preventative measure. There could be one allocated outreach nurse for the borough of Newham and other high-risk areas. Another method implemented in New York was the downsizing of large shelters for the homeless. These were breeding grounds for tuberculosis, and the subsequent reduction in overcrowding led to a decrease in transmission of the disease (Frieden et al., 1995). Whilst it is not possible to split people up from living with their families in crowded homes in terms of Newham, education about keeping those with tuberculosis from interacting with too many others in crowded conditions may be of benefit. The model should also borrow from those used by other cities like Paris and the rest of Europe in controlling tuberculosis with intervention at the level of the agent, individual and community levels. In Paris, Rieder (2002) suggested that prophylactic treatment could be used to prevent the disease occurring in those at risk, for example those in the household of an identified case of tuberculosis. Additionally, Rieder (2002) proposed that early or neonate vaccination be used especially in those in areas where tuberculosis is frequent, rarely diagnosed, and adequate contact examinations rarely feasible. It may be possible that in cases where lots of people are vaccinated that they may infer herd immunity and thus protect unvaccinated individuals from the disease. Once the populations have been protected and the incidence (number of new cases) of tuberculosis has been reduced, this allows for a reduction in the prevalence of tuberculosis (number of ongoing cases at any one point in time) with preventative chemotherapy that can treat sub-clinical, latent tuberculosis in the population. This preventative chemotherapy is likely to be extremely relevant to Newham due to the large immig rant population likely harbouring latent tuberculosis. On a country- or city-wide scale, these recommendations from New York and Paris provide excellent models for preventing the increase of tuberculosis any further. It is also important, however, to consider the individual communities in Newham, and to promote health awareness and an attitude towards taking responsibility for their health. Their needs to be an encouragement at the level of primary care where immigrant populations feel that they can approach healthcare, and education to encourage tuberculosis prevention and adherence to treatment. The strategy should be all-inclusive in order to encourage people to not only go for testing but also start and finish the treatment process. 6. Recommendations and conclusion Tuberculosis presents an important urban issue in the area of Newham. Incidence is greater than other areas of the UK, and is over half that of India. There are several factors contributing to this including a large immigrant population, crowding and overpopulation, access to healthcare and comorbid health problems such as vitamin D deficiency and HIV. The disease has considerable effect on morbidity and is responsible for high levels of mortality. Further consequences of the disease manifest as economic problems such as cost of treatment and loss of work. London and the UK already have policies and structures for controlling tuberculosis in place; however the implementation process is patchy across the city, and often dependent upon budget. In high-risk areas such as Newham, there is poor access of healthcare due to inaccurate beliefs on the disease, language and cultural barriers, and complex needs of the population. In the case of tuberculosis, these contribute to poor disease prevention, delayed diagnosis and poor treatment adherence. All of which lead to an increase in transmission and health consequences. The area of Newham would benefit greatly from further education into tuberculosis, how to look for signs and how to get treatment. Encouraging good relationship with healthcare professionals and promoting access to healthcare through outreach programmes and targeting pharmacies may be helpful. Additionally, Newham should look to employ techniques used in New York and Paris, including DOT, prophylactic treatment and neonate vaccination to reduce both the prevalence and incidence of tuberculosis. References Ahlburg (2000). The economic impact of TB: ministerial conference Amsterdam, WHO Bates, I., Fenton, C., Gruber, J., Lalloo, D., Lara, A. M., Squire, S. B., and Tolhurst, R. (2004). ‘Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part II: determinants operating at environmental and institutional level’.  The Lancet Infectious Diseases,  vol. 4(6), pp. 368-375. Bhunu, C. P., and Mushayabasa, S. (2012). ‘Assessing the effects of poverty in tuberculosis transmission dynamics’.  Applied Mathematical Modelling,  vol. 36(9), pp. 4173-4185. Campbell, G. R., and Spector, S. A. (2012). ‘Vitamin D inhibits human immunodeficiency virus type 1 and Mycobacterium tuberculosis infection in macrophages through the induction of autophagy’.  PLoS pathogens, vol.  8(5). Castillo-Chavez, C., and Feng, Z. (1997). ‘To treat or not to treat: the case of tuberculosis.  Journal of mathematical biology’,   vol. 35(6), pp. 629-656. Colditz, G. A., Brewer, T. F., Berkey, C. S., Wilson, M. E., Burdick, E., Fineberg, H. V., and Mosteller, F. (1994). ‘Efficacy of BCG vaccine in the prevention of tuberculosismeta-analysis of the published literature’.  Jama, vol. 271(9), pp. 698-702. Commonwealth Health Ministers Update 2009. (2009). Commonwealth Secretarial. Dye, C., and Williams, B. G. (2010). ‘The population dynamics and control of tuberculosis’.  Science,  vol 328(5980), pp. 856-861. Dyer, C. A. (2010). Tuberculosis. Santa Barbara, California: Greenwood. Ellner JJ. Tuberculosis. In: Goldman L, Schafer AI, eds.  Goldmans Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011: vol332. Farrar, J., Manson, P. (2013). Mansons tropical diseases. Hoboken, NJ: Wiley. Figueroa-Munoz, J. I., Ramon-Pardo, P. (2008). Tuberculosis control in vulnerable groups.  Bulletin of the World Health Organization,  86(9), 733-735. Frieden, T. R., Fujiwara, P. I., Washko, R. M., and Hamburg, M. A. (1995). ‘Tuberculosis in New York City- turning the tide’.  New England Journal of Medicine,  vol. 333(4), pp. 229-233. Fullman, J., Strachan, D. (2013). Frommers London 2013. Hoboken, NJ: Wiley. Great Britain. (2008). Diseases know no frontiers: How effective are intergovernmental organisations in controlling their spread? ; 1st report of session, 2007-08. London: Stationery Office. Jindal, S. K. (2011). Textbook of pulmonary and critical care medicine. New Delhi: Jaypee Brothers Medical Publishers. London Borough of Newham, (2010). Community Leaders and Engagement, Manor Park Community Forum Profile [Online], Available:newham.info/research/CFProfiles/ManorPark.pdf [12 April 2014]. Malone, C., Beasley, R. P., Bressler, J., Graviss, E. A., Vernon, S. W., University of Texas Health Science Center at Houston, School of Public Health. (2009). Trends in anti-tuberculosis drug resistance from 20032007 at Pham Ngoc Thach Tuberculosis and Lung Disease Hospital, Ho Chi Minh City, Vietnam. (Masters Abstracts International, 47-5.) National Institute for Health and Care Excellence (2006) [Clinical Diagnosis and Management of Tuberculosis, and measures for its prevention and control]. [CG117]. London: National Institute for Health and Care Excellence. Ormerod, L.P. (2003) ‘Nonrespiratory tuberculosis. In Davies PDO (Ed) Clinical Tuberculosis. Third Edition. Arnold: London. pp. 125-153. Public Health England (2012), World Health Organization (WHO) estimates of tuberculosis incidence by rate, 2012 (sorted by rate). [Online] Available at: hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317140584841 [12 April 2014]. Rieder, H. A. (2002).  Interventions for Tuberculosis Control, 1st edn. International Union Against Tuberculosis and Lung Disease, Paris, France. Szczepura, A. (2005). ‘Access to health care for ethnic minority populations’. Postgraduate Medical Journal,  vol. 81(953), pp. 141-147. Vassall, A., University of Amsterdam. (2009). The Costs and cost-effectiveness of tuberculosis control. Amsterdam: Amsterdam University Press. Watson, J. M., and Maguire. H.C (1997). ‘PHLS work on the surveillance and epidemiology of tuberculosis.’ Communicable disease report. CDR review 7.8, pp. R110-2. World Health Organization. (2009). Global tuberculosis control: Epidemiology, strategy, financing : WHO report 2009. Geneva: World Health Organization. World Health Organisation (2014). Tuberculosis. [Online], Available: who.int/topics/tuberculosis/en/ [12 April 2014] UK Census (2012), UK Census Data, [Online]. ukcensusdata.com/newham-e09000025#sthash.51Phmj6a.dpbs [12 April 2014]

Using Quotations in Essays - a Guide

Using Quotations in Essays - a Guide If you want to make an impact on your reader, you can draw on the potential of quotations. The  effective use of quotations  augments the power of your arguments and makes your essays more interesting. But there is a need for caution! Are you convinced that the quotation you have chosen is helping your essay and not hurting it? Here is a checklist to ensure that you are doing the right thing: What Is This Quotation Doing in This Essay? Let us begin at the beginning. You have a chosen a quotation for your essay. But, why that specific quotation? A good quotation should do one or more of the following: make an opening impact on the readerbuild credibility for your essayadd humormake the essay more interestingclose the essay with a point to ponder upon. If the quotation does not meet a few of these objectives, then it is of little value. Merely stuffing a quotation into your essay can do more harm than good. Your Essay Is Your Mouthpiece Should the quotation speak for the essay or should the essay speak for the quotation? Quotations should add impact to the essay and not steal the show. If your quotation has more punch than your essay, then something is seriously wrong. Your essay should be able to stand on its own legs; the quotation should merely make this stand stronger. How Many Quotations Should You Use in Your Essay? Using too many quotations is like having several people shouting hoarse on your behalf. This will drown your voice. Refrain from overcrowding your essay with words of wisdom from famous people. You own the essay, so make sure that you are heard Dont Make it Look Like You Plagiarized Are there any expected standards for using quotations in an essay? Yes, there are. The most important one is that you should not give the impression of being the author of the quotation. That would amount to plagiarism. Here are a set of rules to clearly distinguish your writing from the quotation: Sometimes, you describe the quotation in your own words before using it. In this case, you should use a colon (:) to indicate the beginning of the quotation. Then begin the quotation with a quotation mark (). After you have completed the quotation, close it with a quotation mark (). Here is an example:Sir Winston Churchill made a witty remark on the attitude of a pessimist: A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.Sometimes the sentence in which the quotation is embedded does not describe the quotation, but merely introduces it. In this case, do away with the colon. Simply use the quotation marks. Here is an example:Sir Winston Churchill once said A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.As far as possible, you should mention the author and the source of the quotation. For instance:In Shakespeare’s play As You Like It, Touchstone says to Audrey in the Forest of Arden The fool doth think he is wise, but the wise man knows himself to be a fool. (Act V, Scene I). Ensure that the source of your quotation is authentic. Also, verify the author of your quotation. You can do so by looking up the quotation on authoritative Web sites, such as this one. But for formal writing, do not rely on just one Web site. Blend Quotations In An essay can seem quite jarring if the quotation does not blend in. The quotation should naturally fit into your essay. No one is interested in reading quotation-stuffed essays. Here are some good tips on blending in your quotations: You can begin your essay with a quotation that sets off the basic idea of the essay. This can have a lasting impact on your reader. In the introductory paragraph of your essay, you can comment on the quotation if you like. In any case, do ensure that the relevance of the quotation is communicated well.Your choice of phrases and adjectives can significantly boost the impact of the quotation in your essay. Do not go with monotonous phrases like:George Washington once said...If your essay merits the use of powerful speech, consider using emphatic expressions like:George Washington rocked the nation by saying ... Using Long Quotations It is usually better to have short and crisp quotations in your essay. However, if you are convinced that a particular long quotation is more effective, make sure that you follow the necessary rules. When is it Appropriate to use Long Quotations in Your Essay?:  It is your judgment call. Let me explain. Long quotations must be used sparingly as they tend to weigh down the reader. However, there are times when your essay has more impact with a longer quotation. If you have decided to use a long quotation, consider paraphrasing, as it usually works better. But, there is a flip side to paraphrasing too. Instead of the paraphrase, if you use a direct quotation, you will avoid misrepresentation. As you can see, the decision of using a long quotation is not trivial. Once again, it is your judgment call. Punctuating Long Quotes:  Long quotations should be set off as block quotations. Formatting block quotations should be as per the guidelines that you might have been provided. If there are no specific guidelines, you can follow the usual standard - if a quotation is more than three lines long, you block it. Blocking implies indenting it about half an inch on the left. Often, setting up a long quotation is warranted. Writing a brief introduction displays your understanding of the subject. In other cases, you might need to provide a complete analysis of the quotation. In this case, it is best to state the quotation and follow it with the analysis, rather than the other way around Using Cute Quotes Some students choose a cute quotation first, and then try to plug it into their essay. As a consequence, such quotations drag the reader away from the essay. Quoting poetry:  Quoting a verse from a poem can add a lot of charm to your essay. I have come across writing that acquires a romantic edge merely by including a poetic quotation. If you are quoting from poetry, keep in mind that: A small extract of a poem, say about two lines long, requires the use of slash marks (/) to indicate line breaks. Here is an example: Charles Lamb has aptly described a child as A childs a plaything for an hour;/ Its pretty tricks we try / For that or for a longer space; / Then tire, and lay it by. (1-4) If you use a single line extract of a poem, punctuate it like any other short quotation without the slashes. Quotation marks are required at the beginning and at the end of the extract. However, if your quotation is more than three lines of poetry, I would suggest that you treat it like you would have treated a long quotation from prose. In this case, you should use the block quote format. Does Your Reader Understand the Quotation? Do you use quotations in your essays? Surely you follow the expected standards. But, that may not be enough. Having followed all the standards and punctuation, you must ask the critical question: Do readers understand the quotation and its relevance to my essay? If the reader is re-reading a quotation, just to understand it, then you are in trouble. So when you choose a quotation for your essay, ask yourself the following questions: Is this too convoluted for my reader?Does this match the tastes of my audience?Is the grammar and vocabulary in this quotation understandable?

Econometrcs Essay Example | Topics and Well Written Essays - 2000 words

Econometrcs - Essay Example Accordingly the log-log model was found consistent with the economic theory. For example, the coefficient of own price was not significant while the coefficient of output price was negatively correlated in the linear-linear model. Cost minimizing farmers’ input demand however, should be positively correlated to the output price i.e. with increasing output price which in turn increase farmer’s profit the demand for inputs also should increase. Therefore, in the urea fertilizer demand model the paddy price should be positively correlated with the fertilizer demand. And also the price of urea should be negatively and significantly correlated to the demand for urea. Hence the log-log model is consistent with the economics theory. Therefore, it was used for interpretation as follows. Table2: Test for Autocorrelation Breusch-Godfrey LM test for autocorrelation lags(p) chi2 df Prob > chi2 1 0.520 1 0.4709 H0: no serial correlation N*R2 = 23*0.516 = 11.868 N*R2 > chi2 Therefore reject H0. There is auto correlation in the model. Thus the robust estimates were taken. Table3: Test for Multicolinarity Variable VIF 1/VIF Log-Urea Price (Rs/Kg) 2.67 0.37453 Log- Open Market Price of Paddy (Rs/Mt) 2.42 0.41322 Log- Wages (Rs/Day) 2.08 0.48072 Log- Lag dependent 1.58 0.63344 Mean VIF 2.19 ii) In log-log equations the coefficients reflects the price elasticity of the respective variables. For example in the above model the own price elasticity of urea demand is -0.0561 i.e. with 1 percentage proportion decrease in urea price the increase the demand for urea by 5.6 percentage proportion. Similarly, the elasticity of urea demand for paddy price is 0.459 i.e. 1 percentage proportion increase in open market price of paddy can increase the demand for urea fertilizer by 45.9 percentage proportion. In the model the largest, significant coefficient was associated with the open market price of paddy. This shows that paddy farmers production decisions are influenced highly by the output price compared to the price of other factors of production such as fertilizer, labor and crude oil. However both own price elasticity and output price elasticitys are less than one and hence are inelastic. The demand for fertilizer is negatively correlated to the wage rates and crude oil prices. With increasing wage rates and oil prices the cost of production increase and hence these variables are negatively correlated in the demand model. The elasticity of demand with respect to wage rates is -0.261 while the elasticity of demand with respect to crude oil price is -0.145. therefore the demand for urea fertilizer decrease by 26.1 and 14.5 percentage proportions with respect to 1 percentage proportion increase in wage rates and crude oil prices respectively. Crude oil price represent the transport cost and also paddy processing costs. The goodness of fit as denoted by the adjusted R2 value of the above model is 51.6 percentage proportion and the probability value of the f statistic was 0.00. Therefore the model is statistically significant

Amenorrhea Case Study Example | Topics and Well Written Essays - 1000 words

Amenorrhea - Case Study Example This paper will discuss a case study that involves a 30-year-old female whose has secondary amenorrhea for six months. Prior to being diagnosed with the disorder, she presented with periods of irregular cycles and dysmenorrhea. Thus, the paper will discuss the pathophysiology of the disorder and it possible causes in relation to irregular cycles and dysmenorrhea. Amenorrhea is a menstrual disorder that refers to the absence of menstruation in a woman who had been previously having their normal menstrual cycle. Secondary is used to refer to menstruation that had previously occurred at least for some period but stopped for a period of six months or longer due to some reasons. In order for the woman to be diagnosed with secondary amenorrhea, they must miss their menstrual period for a period of at least three to six months without being pregnant (Heiman, 2009). The most significant contributing factors include the use of birth control pills, certain medications and stress that also have been associated to cause dysmenorrhea (painful cramping) and irregular cycles. The most common reason as to why a woman will miss their period is as a result of pregnancy. However, it should be noted that pregnancy, menopause and breastfeeding are not classified as causes of the disorder. Secondary amenorrhea is not harmful to the patients’ health as it c an be treated effectively in the majority of the cases according to the pathophysiology. Thus, it is important for the health care practitioner to address the underlying condition causing the menstrual disorder to ensure that optimal health of the woman is regained (Klein & Poth, 2013). The hypothalamus is involved in generating the gonadotropin-releasing hormones that are responsible for stimulating the pituitary gland to produce the gonadotropins i.e. the Luteinizing Hormone and Follicle- stimulating hormone into the blood stream. These gonadotropins are important in

The Role of Setting in John Steinbecks Of Mice & Men Essay -- Steinbe

The Role of Setting in John Steinbeck's Of Mice & Men Throughout time man has encountered many trials and tribulations. One of these unpredictable changes was the depression era in the Western region of America. From the beginning to the end of the novel, Of Mice & Men (1937), by John Steinbeck, life is portrayed as cruel and an insurmountable conquest. During the 1930's the worst economic collapse of the world occurred : the Depression. The setting throughout this novel sets the emotions high because of the hardships that were encountered by two men looking for work. These men were George Milton and Lennie Small. George was "small and quick and hard of the face, and had sharp strong features" (9). Lennie was the opposite a " huge man, shape less of a face, with large, pale eyes, with wide sloping shoulders" (9). While the simple minded and powerful Lennie tries to keep out of trouble at the ranch, he worries about how George may get angry at him if he makes a blunder. Curly, the boss's son, is a trouble maker and pressures Lennie into fighting him which he does and pays the price. In addition, Lennie ends up killing Curley's wife, thus leading to the death of Lennie. George shoots him utilitarianly, which means he did it to bring safety to anyone who may have encountered him. With Lennies death George hoped to maximize happiness for the greatest number of people. Their dream once of having their own ranch died with Lennie. Setting is encountered in every chapter and allowing the reader to visualize the surroundings which contribute to this story more than any other element. The story is set in 1930's California on the verge of Mexico. The river Steinbeck speaks of, "The Salinas River," happens to be the birthplace of Stei... ...lood." This brings the story to and end when George killed his one and only friend, Lennie. Ironicaly, Steinbeck was a marine biologist and when he wrote this book he was in the ways of looking at water. The pond that Lennie drank out of, which the river that ran into it came from his home town, and the cruel view of nature as the snake that probably ate the mouse that Lennie killed was devoured by a heron. Thus, showing that things have a chain reaction in nature and Lennie, some what, got revenged upon by the mouse and the other mammals that he killed. The setting is the biggest element of the novel setting the mood at the begining of each chapter and vividly examining the way it was during the depression. This finally answers the question "Where did I go George?" Work Cited Steinbeck, John, "Of Mice and Men." (1937). May 3, 2004. New York, New York.

How to be successful person?

Nowadays, there are many successful athletes, who dedicated their lives to be healthy, because inâ€Å"A Healthy Mind In a Healthy Bodyâ€Å". We all know that sports play an important role in our life, but to become a true sportsman one should possess the quality of head an heart We should take athletes as example for us, because of their courage and ambitions.. One of the most important quality of a sportsman is sportsman ship. Sportsman ship means the true spirit of taking part in sports. A sportsman should never use unfair means for personal gain.Sportsmen should strongly avert on eating fast food because fast food contains excess amount of fat and salt which is unfavourable and an obstacle to becoming a successful sportsman. An excellent sportsman incorporates many traits such as powerful physique, keen senses, discipline, calm and yet gregarious and outgoing. Enough sleep and rest is also a major requisite for becoming a successful sportsman. A sportsman also should have fore sight quick thinking, especially during the team play, for example football.As for me, becoming a successful sportsman just requires integrity and perseverance. If you want to be successful person in your live, you should have some important qualities in your character. In the world there are many successful persons in different area. For example, Margaret Thatcher was a British politician who was the Prime Minister of the United Kingdom. She was the longest-serving British Prime Minister of the 20th century and is the only woman to have held the office.Margaret Thatcher was hard-working person, who very want to achieve her aim in life. No doubt, that in her character was qualities as determination, diplomacy, foresight, discipline. If you want to achieve success how Margaret Thatcher, you should also have quick thinking, power of persuasion. Another key to be success is in good education. If you study hard, you receive great result and big intellect, which help you have everything, that you want.

Analysis and Comparison of Ulysses and the Sirens and “Siren Song” - Free Essay Example

Sample details Pages: 3 Words: 768 Downloads: 6 Date added: 2019/02/20 Category Literature Essay Level High school Topics: Poetry Analysis Essay Did you like this example? Introduction In the human experience, it is so easy to fall for simple tricks that seem like acts of kindness. One way to prove this is the mythological creature the siren. The sirens sing a beautiful song, which seems like an act of kindness, but they sing it for evil. The song traps sailors on an island where they die. Don’t waste time! Our writers will create an original "Analysis and Comparison of Ulysses and the Sirens and â€Å"Siren Song†" essay for you Create order In the painting Ulysses and the Sirens, John William Waterhouse uses the scene of Sirens trying to mesmerize Odysseus’ crew to show that it is easy for humans to get distracted by their problems and become easily overwhelmed, while in â€Å"Siren Song†, Margaret Atwood uses the same scene to show that humans often get deceived by people who seem kind, but actually hope for the worse. Poetry Analysis The poem by Atwood takes place in the thoughts of a siren. Whoever hears the siren song dies, but the speaker is tired of singing it. She is claiming that the song is a call for help, but this could easily be another trap In the poem, the speaker states, â€Å"This song is a cry for help: Help me!† (Atwood 22) In conclusion, the speaker is saying she is trapped and has no escape, we will never know whether this is just another trap or if she is being honest. Research about the Poet Atwood was born in Ontario, Canada on November 18, 1939. She started writing at the age of 5. Since then, she has written 27 poems. Not only has she achieved this much, she also earned a master’s degree in English Literature from Radcliffe COllege in 1962. Her poems all basically have the same theme, which is human behavior. Out of all of her achievements, her best was probably winning the PEN Pinter Prize for the spirit of political activism in 2016. Atwood is a very experienced and encouraging writer. She claims that the only reason the female characters in her poems are suffering is because every woman she has talked to about personal experiences has suffered. In conclusion, Atwood is a great role model for anyone who is looking for a future in writing. Not only is she a great writer, her poems are very inspirational and interesting. Painting Analysis The mood of the painting can be described as overwhelming, which demonstrates the idea that Odysseus’s crew is overwhelmed with stress. The poem demonstrates stress in comparison to human experiences by showing the sirens as problems, and Odysseus’s crew as the humans being overwhelmed by their problems. The sirens are tempting and deceiving, while the crew is trying their best to not fall for the trap, it is very hard for them which causes stress. In conclusion, the artist is trying to show that humans have to use all of the strength they have to avoid their temptations. Even though the sirens are singing as beautifully as they could, the crew thought ahead of time and planned for temptations. Research About the Artist John William Waterhouse lived a very fulfilling life. He was born on April 6, 1849. He produced over 200 paintings in his whole lifetime. The paintings by Waterhouse depicted scenes of tragedy, betrayal, and love. Sadly, Water house died at the age of 68 due to cancer. His last painting made was titled The Enchanted Garden. Even though Waterhouse had cancer, he still continued to perservere with his painting and he ended up being very succesful. In conclusion, Waterhouse worked hard and it payed off in the end of things, no matter what age he was, he was still very prosperous. Theme that Connects Poem and Painting The main theme that connects the poem and painting is deception. The sirens are very deceptive creatures just simply by singing. In both the painting and the poem, the sirens are singing and tricking sailors who pass by simply using flattery. In conclusion, the painting and poem both have a very universal theme, which is to not fall for simple temptations. Conclusion In the painting Waterhouse uses the scene of Sirens trying to mesmerize Odysseus’ crew to show that it is easy for humans to get distracted by their problems and become easily overwhelmed, while in â€Å"Siren Song†, Atwood uses the same scene to show that humans easily get deceived. The painting and the poem both express the idea that humans are easily tricked by small obstacles or even each other. Both the painting and the poem had two different moods, yet they still have the same theme. The painting has a mood that shows stress, however the poem has a mood of sadness. The theme of these two pieces of art is deception.